Consequences

The family gathers in the waiting area, holding hands, exchanging stories. The surgeon appears. He’s done this operation many times before, he assures them. The family offers reassurance to the patient as well. Hugs are exchanged, along with a final kiss from his wife of 50 years. Off rolls a husband, a father, a grandfather—entrusting his life to a man he’s spoken with for less than 30 minutes.

In the operating room, lines are in place and checklists are completed. The team has done this routine many times before. The belly is opened; everyone knows the process from here. The surgeon’s hand reaches in, but something feels different than the images displayed on the monitor. What seemed small before has now grown and is near the major vascular structures. The surgeon ponders the next move, constantly assessing the risk of proceeding. To resect is to cure; to not resect is failure. Heal by steel it is, and they press on.

The dissection is tedious, the exposure difficult. Frustration mounts as the lighting just never seems quite right. Red flags are all around, but to not resect is failure. Then the bleeding starts. The open cavity fills torrentially. The patient’s blood pressure drops, while the heart rate rises. The head of the table is now a flurry of activity. Sponges are used in an attempt to quell the crimson surge but to no avail. The monitor alarms. The pulse is absent. Compressions begin, but this chapter is closed. No more morning strolls with his wife. No more weekends manning the grill with his son during football season. No more pushing his granddaughter on the backyard swing.

The family gathers in the consultation room. Once jovial, they now sit in silence, waiting, hoping. On the other side of the restricted area, the surgeon changes his soiled scrubs. His mind races. What if he had just improved the exposure? He rinses the blood splatter from his neck. What if he hadn’t pushed forward?

The door opens, the surgeon removes his cap. He did all he could. The tumor was large. There was bleeding. His heart could not take the stress. He’s passed. Tears flow as everyone gathered huddles together in a consoling embrace. There are no dry eyes except for the surgeon. He weeps within—weeps for what he’s done.

His peers will offer solace—the tumor was large, the tissue quality was poor. His heart was already in suboptimal condition. Inside he knows this outcome was avoidable. Knows his pride put this man in danger. Knows the void now created in this family. Knows these feelings will trouble him for days, weeks, months, years.

But there isn’t time to ponder these consequences. The next case is on the table.